Sexual dysfunction associated with oral antihypertensive medication: A critical survey of the literature

It is a commonly held clinical belief that antihypertensive agents affect sexual performance. The authors survey the English language literature concerning oral antihypertensive agents and critically review studies examining sexual side effects. Suprisingly, few studies support much of the conventional clinical wisdom. Evidence is strong for the pathogenicity of guanethidine upon ejaculatory mechanisms. Contrary to expectation, strong evidence also exists for the ability of propranolol, especially in high doses, to inhibit erectile functioning. Only equivocal support was found for the pathogenicity of methyldopa, reserpine, and clonidine upon sexual functioning. The authors suggest that this may be in part due to underdeveloped methodology for assessing the sexual side effects of hypertensive medications. Suggestions are offered for future studies as well as for the clinical evaluation of sexual dysfunction in the hypertensive patient.     

Nonanastomotic hepaticogastrostomy for palliative decompression.

A simple, low risk technique has been used in two patients with high malignant obstruction of the common hepatic bile duct for the creation of a biliary enteric fistula.     

The effect of biliary obstruction on some properties of alkaline phosphatase of rat liver

Alkaline phosphatase in extracts of livers of rats with occluded bile ducts is significantly more stable to heat than the enzyme extracted from normal liver. There is also some increase in the ratio of orthophosphatase to inorganic pyrophosphatase activity in the former case, but no differences were detected in electrophoretic mobility or in Michaelis constants for orthophosphate hydrolysis. Within a particular group of animals, e.g. normal or bile duct-ligated, the properties of the enzyme show little variation.     

Pre-estrogen breast irradiation for patients with carcinoma of the prostate: a critical review.

We studied 38 patients with prostatic cancer who received breast irradiation before oral estrogen administration. Our data are combined with those from other institutions to determine the effectiveness of pre-estrogen breast irradiation in minimizing gynecomastia and/or pain. Based on our review the incidence of estrogen-induced breast changes is 70%. Irradiation given before estrogen administration can prevent or minimize these changes in 89.3% of the treated patients. Histologic changes of gynecomastia are reviewed and recommendations for optimum radiation therapy technique are included.